Organization
AMBULATORY SURGERY CENTER OF OPELOUSAS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TANIA TORRES (SUPERVISOR)
(504) 832-2115
Entity
Organization
Contact information
Practice address
187 VENTRE BLVD, OPELOUSAS, LA 70570-9145
(337) 407-0050
(337) 407-0073
Mailing address
1207 N CAUSEWAY BLVD, METAIRIE, LA 70001-4129
(504) 832-2115
(504) 832-2116
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
114
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11083
PTAN
LA
05
—
1148199
—
LA
01
—
190020205Z
BLUE CROSS OF LA
LA
Enumeration date
08/19/2006
Last updated
03/27/2012
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